Objective To investigate the causes of an outbreak of healthcare-associated infection with methicillin-resist-ant Staphylococcus aureus (MRSA)in a neurosurgical intensive care unit(NSICU).Methods Epidemiological investigation on 8 patients with lower respiratory tract infection (LRTI)in a NSICU between June 15 and June 28,2104 were performed by combination methods of prospective and retrospective survey.Results The attack rate of MRSA LRTI in NSICU patients was 22.86%,a total of 16 MRSA isolates were detected from patients’clinical specimens,nasal vestibule,as well as hospital surroundings during the period,pulsed-field gel electrophoresis (PFGE)result revealed that infection outbreak was caused by two subtypes of MRSA;risk factors analysis showed that long length of stay in ICU and aspiration of spu-tum through bronchoscopy were risk factors for MRSA LRTI.Conclusion Contamination of bronchoscope was the key factor for this epidemic spread of healthcare-associated MRSA infection.

Objective To understand the effect of improving compliance rate to multidrug-resistant organism (MDRO)prevention and control measures on reducing MDRO transmission in the intensive care unit (ICU ). Methods All patients in 5 ICUs of a hospital in March-June 2014 were chosen,March 1-April 30,2014 was base-line survey stage,May 1-June 30,2014 was intervention stage (comprehensive intervention measures were taken), the implementation of patients contact isolation measures,as well as awareness of MDRO-related knowledge among health care workers(HCWs)in 5 ICUs before and after intervention were compared respectively. Results HCWs' awareness rates of MDRO transmission modes,contact isolation measures,and informing of department transfer after intervention were all higher than before intervention(100.00% vs 67.22% ,98.89% vs 61.11% ,93.33% vs 45 .56% ,respectively);except single-room isolation,compliance rates to other prevention and control measures (including doctor's advice on isolation,bedside isolation,wearing isolation gowns,adding isolation logo)were all higher than before intervention(>70% vs <50% ,all P<0.01). Detection rate of MDROs after intervention was lower than before intervention (7.16% [90/1257]vs 9.65% [117/1212],χ2= 5.00,P= 0.03). Conclusion Com-prehensive intervention measures can improve HCWs'compliance to prevention and control measures on MDROs, and reduce the transmission of MDROs.

Objective To study the impact of earthquake disasters on the mental health of military medical personnel during emergency rescue. Methods Three hundred military medical personnel who participated in the emergency rescue of earthquake disasters in five military hospitals in Shaanxi Province were selected as the study subjects, and their mental health levels were analyzed using the Mental Symptom Checklist 90 (SCL-90). Results In this survey, a total of 300 SCL-90 questionnaires were issued, 300 were recovered, and the effective recovery rate was 100%. Only 30.67%(92/300) of people participated in emergency disaster rescue during investigation, 31.33% (94/300) had psychological problemsafter arriving in the earthquake-stricken area after one week, such as somatization, obsessive-compulsive disorder, anxiety, and horror. SCL-90 scores were 0.45±0.03, 1.13±0.13, 0.79 ±0.08, 1.07±0.09, 1.01±0.14. The psychological stress response rates of the emergency response of military medical staff of different characteristics were different. Among them, the stress response rates of military personnel with different degrees (specialty, bachelor or above) and whether they have participated in rescue work were 74.07% (40/54), 21.95% (54/246), 15.22% (14/92), 38.46% (80/208).The difference was statistically significant (χ2=55.913,16.018, P<0.01). Conclusions The medical staff of the army participating in the earthquake disaster rescue has psychological pressure due to many injuries, environmental risks, lack of supplies, etc. The medical unit should provide adequate training in theory and practice to its personnel and focus on the mental health of rescue workers, give timely psychological counseling to ensure the successful completion of the rescue.